Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tenoxicam, a non-steroid anti-inflammatory of the oxicam type, has a molecular structure similar to that of piroxicam, but is more active and better tolerated. Several studies demonstrated that tenoxicam is a potent analgesic. It is completely absorbed after oral and intramuscular administration and slowly eliminated, the long half-life in tissues consenting once-daily administration. In the present study the pharmacokinetics of tenoxicam have been investigated during repeated parenteral administration, with or without loading dose, in order to establish the dose regime that produces constant tissue concentrations over time. Thirty-six patients of both sexes, suffering from acute pain due to arthritis of the spine, were enrolled in the study and divided into three equal groups. The first group was given 40 mg tenoxicam per day (single i.m. injection) for 2 days followed by 20 mg (single i.m. injection) for 10 days. The second group received 20 mg i.m. once a day for 12 days. The third group received 20 mg i.m. twice a day for two days followed by single 20 mg i.m. injections on the following days. Blood was sampled at 0, 0.5, 1,2,4,6,8,12,16 and 24 hours and at 3,5,7,9 and 12 days. Tenoxicam levels in the samples were assayed by an HPLC method. The results showed that single 40 mg loading doses for 2 days, followed by once-daily 20 mg maintenance administration, established the requisite steady-state tissue concentrations of tenoxicam after the second administration. Tenoxicam was very well tolerated in all three groups.
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PMID:Pharmacokinetics of tenoxicam at different dosage regimes. 825 88

Spondyloarthritis (SpA) is a chronic inflammatory disease with either predominantly axial symptoms of the spine and sacroiliac joints (axial SpA, including ankylosing spondylitis) or predominantly arthritis (peripheral SpA). Next to these spinal and articular symptoms, many patients with SpA also have extra-articular manifestations (EAMs). EAMs associated with SpA include anterior uveitis (25-30%), psoriasis (10-25%) or inflammatory bowel disease (IBD) (5-10%) and cardiovascular manifestations. Peripheral arthritis occurs in approximately 30% of patients, especially in large joints, and shows an asymmetrical, oligoarticular pattern. Other common joint complaints are due to enthesitis, which manifest as extra-articular bony tenderness in areas such as the Achilles tendon. Acute anterior uveitis presents with acute pain, loss of vision and redness in one eye that usually subsides spontaneously after several weeks. Rapid treatment by an ophthalmologist is required to prevent synechiae formation which could ultimately result in glaucoma and blindness. Although less common, organ involvement in SpA can also be located in the heart, lungs or kidneys. The risk of cardiovascular events is increased in SpA. Cardiac manifestations can involve the aortic valve (1-10%) or the atrioventricular node and the risk of atherosclerotic events is increased in this group. Treatment of SpA includes physical exercise and nonsteroidal anti-inflammatory drugs (NSAIDs), and in case of peripheral arthritis, sulphasalazine can be added. When there is insufficient response to NSAIDs, tumor necrosis factor blockers, especially infliximab, etanercept, adalimumab and golimumab, are very effective in treating axial manifestations, arthritis, enthesitis and psoriasis. Anterior uveitis in SpA can be treated adequately by the ophthalmologist and in the case of refractory uveitis, treatment with adalimumab and infliximab seems to be more effective compared with etanercept. When IBD occurs with SpA, the use of NSAIDs should be minimized, except for celecoxib, and infliximab or adalimumab are preferred to etanercept. The incidence of atherosclerotic events or SpA-specific cardiac manifestations may be decreased by cardiovascular risk management or effective antirheumatic treatment. Overall it is important to realize that extra-articular manifestations frequently occur in patients with SpA and should be taken into account in the choice of treatment.
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PMID:Management and evaluation of extra-articular manifestations in spondyloarthritis. 2322 18